title: Pulmonary vein isolation in patients with Brugada syndrome and atrial fibrillation: a 2-year follow-up.
abstract: OBJECTIVE
  Pharmacological treatment of atrial fibrillation (AF) in the setting of Brugada syndrome (BS) might be challenging as many antiarrhythmic drugs (AADs) with sodium channel blocking properties might expose the patients to the development of ventricular arrhythmias. Moreover, patients with BS and implantable cardioverter-defibrillator (ICD) might experience inappropriate shocks because of AF with rapid ventricular response. The role of pulmonary vein isolation (PVI) in patients with BS and recurrent episodes of AF has not been established yet. In this study, we analysed the outcome of PVI using radiofrequency energy or cryoballoon (CB) ablation at 2 years follow-up.
  
  
  RESULTS
  Consecutive patients with BS having undergone PVI for drug-resistant paroxysmal AF were eligible for this study. Nine patients (three males; mean age: 52 ± 26 years) were included. Six patients (67%) had an ICD implanted of whom three had inappropriate shocks because of rapid AF. At a mean 22.1 ± 6.4 months follow-up, six patients (67%) were free of AF without AADs. None of the three patients who had experienced inappropriate ICD interventions for AF had further ICD shocks after ablation.
  
  
  CONCLUSIONS
  In our study PVI can be an effective and safe procedure to treat patients with BS and recurrent episodes of paroxysmal AF.
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Laarbeeklaan 101, 1090 Brussels, Belgium.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
authors.forename: Carlo
authors.initials: C
authors.lastname: De Asmundis
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Moises
authors.initials: M
authors.lastname: Levinstein
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.forename: Ruben
authors.initials: R
authors.lastname: Casado-Arroyo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D053840:Brugada Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects; D003452:Cryosurgery / Q000009:adverse effects; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012042:Registries; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial Fibrillation; Brugada syndrome; Cryoballoon; Pulmonary vein isolation; Radiofrequency